Competency
- AN15.5: Describe and demonstrate adductor canal with its contents.
Introduction
The adductor canal is an intermuscular passage located on the medial side of the middle one-third of the thigh. It provides a pathway for the femoral vessels and other neurovascular structures as they pass from the femoral triangle to the popliteal fossa.
Other Names
The adductor canal is also known as:
- Subsartorial canal because it is covered by the sartorius muscle.
- Hunter’s canal, named after John Hunter, who used this region for surgical treatment of popliteal aneurysms.
Length
The adductor canal is approximately 15 cm long.
Extent
The canal extends from the apex of the femoral triangle superiorly to the adductor hiatus (tendinous opening in the adductor magnus) inferiorly.
Shape
In cross-section, the adductor canal is triangular.
Boundaries of Adductor Canal
The adductor canal has three walls.
Anterolateral Wall
- Vastus medialis
Posteromedial Wall
- Adductor longus (upper part)
- Adductor magnus (lower part)
Anteromedial Wall (Roof)
The roof is formed by:
- A strong fibrous membrane called the subsartorial fascia, which extends between the anterolateral and posteromedial walls.
- The sartorius muscle, which lies superficial to the subsartorial fascia.
Note: The subsartorial plexus of nerves is located between the subsartorial fascia and the sartorius muscle.
Subsartorial Nerve Plexus
The subsartorial nerve plexus is a network of nerves located on the subsartorial fascia, beneath the sartorius muscle.
Formation
The plexus is formed by contributions from:
- Medial cutaneous nerve of the thigh
- Saphenous nerve
- Anterior division of the obturator nerve
Distribution
The subsartorial plexus supplies:
- Fascia lata over the medial thigh
- Skin covering the medial aspect of the thigh
Contents of Adductor Canal
The adductor canal contains the following structures:
- Femoral artery
- Femoral vein
- Saphenous nerve
- Nerve to vastus medialis
- Branches of the anterior and posterior divisions of the obturator nerve
- Descending genicular artery
CLINICAL INTEGRATION
- John Hunter first ligated the femoral artery in the adductor canal to treat a popliteal artery aneurysm.
- Adductor canal block: A local anesthetic is injected into the adductor canal to block the saphenous nerve, providing analgesia to the medial side of the leg.
- Adductor canal compression syndrome: Compression of the neurovascular bundle by hypertrophied muscles may cause:
- Intermittent claudication due to femoral artery compression.
- Pain, numbness, or paresthesia due to saphenous nerve compression.
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